23 research outputs found
Stream Crossing Barrier Prioritization Methods for Increasing Eastern Brook Trout Habitat in the Little Androscoggin River Watershed
Eastern Brook Trout (Salvelinas fontanalis) are an important cold water fishery in the state of Maine. While populations in Maine are relatively abundant there has been decline in some parts of its range due in part to loss of habitat connectivity. Brook trout require access to specific types of stream habitat for spawning, feeding, and seasonal thermal refuges. Stream crossing structures such as undersized, poorly installed, or blocked culverts, as well as small remnant dams, can create barriers to accessing important stream habitat for brook trout. A recent Fish Barrier/Culvert Survey in the Little Androscoggin River Watershed provided data about crossing structures and stream conditions that was used to identify barriers that were limiting connectivity of stream habitat. The data was used to prioritize identified barriers in terms of creating better access to higher quality and quantity of stream habitat. To accomplish this the survey data was processed using the Barrier Assessment Tool, a GIS tool that is used to calculate quantities of stream habitat that could be gained both up and downstream of identified barriers. Then raster data for several key parameters of high quality brook trout habitat was created, re-classified and given weighted values. Overlays of the weighted rasters were used to identify the stream reaches with best habitat value. Using the combination of these two methods, identified barriers can be prioritized for future remediation, assisting with efforts to strategically reconnect fragmented Eastern Brook Trout habitat
Addition of elotuzumab to lenalidomide and dexamethasone for patients with newly diagnosed, transplantation ineligible multiple myeloma (ELOQUENT-1): an open-label, multicentre, randomised, phase 3 trial
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
A randomized clinical trial of trans-dermal nicotine replacement in pregnant African-American smokers.
We compared acceptability, adherence and efficacy of trans-dermal nicotine patches and cognitive behavioral therapy (Group 1) to cognitive behavioral therapy alone (Group 2) in minority pregnant smokers. This is a randomized controlled trial. 52 women were recruited during pregnancy with a mean gestational age 18.5 ± 5.0 weeks and followed through delivery. Randomization was by site and initial cotinine levels. Interventionists and interviewers were blinded to group assignment. Two different nicotine replacement therapy dosing regiments were administered according to the baseline salivary cotinine level. A process evaluation model summarized patient adherence. The main outcome measure was self-report of cessation since last visit, confirmed by exhaled carbon monoxide. Analyses of categorical and continuous measures were conducted as well as linear trend tests of salivary cotinine levels. Women lost to follow-up were considered treatment failures. Participants were on average 27.5 ± 5.4 years old, 81 % were single, 69 % unemployed and 96 % were Medicaid eligible. A process evaluation indicated patients in both groups were adherent to scheduled program procedures through Visit 4, but not for Visits 5 and 6. Confirmed quit rates were: at visit 3, 23 (Group 1) and 0 % (Group 2) (p = 0.02); at visits 4 and 5, no difference; at visit 6, 19 (Group 1) and 0 % (Group 2) (p = 0.05). Group 1 delivered infants with a mean gestational age of 39.4 weeks versus 38.4 weeks in Group 2 (p = 0.02). 73 % (52/71) of the eligible smokers agreed to participate and 65 % (17/26) of Group 1 completed the protocol (i.e. attended 6 visits). A comparison of Group 1 and 2 quit rates confirmed a non-significant difference
A Randomized Clinical Trial of Trans-Dermal Nicotine Replacement in Pregnant African-American Smokers
Assessing Potency of High- and Low-Preference Reinforcers with Respect to Response Rate and Response Patterns
Previous research has suggested that the availability of high-preference stimuli may override the reinforcing efficacy of concurrently available low-preference stimuli under relatively low schedule requirements (e.g., fixed-ratio 1 schedule). It is unknown if similar effects would be obtained under higher schedule requirements. Thus, the current study compared high-preference and low-preference reinforcers under progressively increasing schedule requirements. Results for 3 of the 4 participants indicated that high-preference stimuli maintained responding under higher schedule requirements relative to low-preference stimuli. For 1 participant, high-preference and low-preference stimuli were demonstrated to be equally effective reinforcers under increasing schedule requirements. Implications with respect to rate of performance and response patterns are discussed
Impairment of the transient pupillary light reflex in Rpe65K/K mice and humans with lebergenic mice was developed to control gene expression at temporal and spatial level to check for a reversal point (Chang et al., 2000; Angeletti et al., 2003). A rapid
PURPOSE. To determine the impairment of the transient pupillary light reflex (TPLR) due to severe retinal dysfunction and degeneration in a murine model of Leber congenital amaurosis (LCA) and in patients with the disease. METHODS. Direct TPLR was elicited in anesthetized, darkadapted Rpe65 Ϫ/Ϫ and control mice with full-field light stimuli (0.1 second duration) of increasing intensities (Ϫ6.6 to ϩ2.3 log scot-cd ⅐ m Ϫ2 ). 9-cis-Retinal was administered orally to a subset of Rpe65 Ϫ/Ϫ mice, and TPLR was recorded 48 hours after the treatment. TPLR was also measured in a group of patients with LCA. RESULTS. Baseline pupillary diameters in Rpe65 Ϫ/Ϫ and control mice were similar. TPLR thresholds of Rpe65 Ϫ/Ϫ mice were elevated by 5 log units compared with those of control animals. The waveform of the TPLR in Rpe65 Ϫ/Ϫ mice was similar to that evoked by 4.8-log-unit dimmer stimuli in control mice. Treatment of Rpe65 Ϫ/Ϫ mice with 9-cis-retinal lowered the TPLR threshold by 2.1 log units. Patients with LCA had baseline pupillary diameters similar to normal, but the TPLR was abnormal, with thresholds elevated by 3 to more than 6 log units. When adjusted to the elevation of TPLR threshold, pupillary constriction kinetics in most patients were similar to those in normal subjects. CONCLUSIONS. Pupillometry was used to quantify visual impairment and to probe transmission of retinal signals to higher nervous centers in a murine model of LCA and in patients with LCA. Mouse results were consistent with a dominant role of image-forming photoreceptors driving the early phase of the TPLR when elicited by short-duration stimuli. The objective and noninvasive nature of the TPLR measurement, and the observed post-treatment change toward normal in the animal model supports the notion that this may be a useful outcome measure in future therapeutic trials of LCA. (Invest Ophthalmol Vis Sci
Effect of a group intervention to promote older adults’ adjustment to driving cessation on community mobility: a randomized controlled trial
Objectives: The UQDRIVE program, a group education and support program, was developed to meet the needs associated with driving cessation for older adults. The current study investigated the effect of the program on community mobility. Design and Methods: A prospective, parallel, stratified randomized controlled trial was undertaken with a waitlist control group receiving current clinical practice (no intervention). Data were collected pre, post, and 3 months following the intervention. Participants were adults aged 60 years or older who had ceased driving or planned to cease driving within 12 months. Results: A total of 131 participants were included in analyses (67 intervention, 64 control). Participating in the intervention was significantly associated with a higher number of episodes away from home per week at immediately postintervention (z = 2.56, p = .01). This was not significantly maintained at 3-month follow-up. Participation in the intervention also significantly predicted higher use of public transport at immediately postintervention (z = 2.12, p = .034), higher use of walking at immediately postintervention (z = 2.69, p = .007), increased aspects of community mobility self-efficacy (z = 3.81, p = .0001), and higher satisfaction with transport at 3-month follow-up (z = 2.07, p = .038). Implications: The program increased community mobility immediately postintervention and transport satisfaction at 3 months postintervention. Due to a high attrition rate, further research is required to clarify the long-term impact of the intervention